High priority for hepatitis C screening in safety net hospitals: Results from a prospective cohort of 4582 hospitalized baby boomers. Issue 5 (29th August 2015)

• Record Type: Journal Article
• Authors: Turner, Barbara J.; Taylor, Barbara S.; Hanson, Joshua; Liang, Yuanyuan; Veerapaneni, Poornachand; Villarreal, Roberto; Perez, Mary; Hernandez, Ludivina; Sandhu, Jasdeep; Fiebelkorn, Kristin
• Is Part Of: Hepatology. Volume 62:Issue 5(2015:Nov.)
• Page Start: 1388
• Page End: 1395
• Publication Date: 2015-08-29
• Subjects: Heart -- Diseases -- Nursing -- Periodicals; Lungs -- Diseases -- Nursing -- Periodicals; Intensive care nursing -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1002/hep.28018
• Languages: English
• ISSNs: 0270-9139

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Low‐income populations are disproportionately affected by hepatitis C virus (HCV) infection. Thus, implementing baby boomer screening (born 1945‐1965) for HCV may be a high priority for safety net hospitals. We report the prevalence and predictors of HCV infection and advanced fibrosis or cirrhosis based on the Fibrosis‐4 score plus imaging for a baby boomer cohort admitted to a safety net hospital over a 21‐month interval with >9 months of follow‐up. Anti‐HCV antibody testing was performed for 4582, or 90%, of all never‐screened patients, of whom 312 (6.7%) tested positive. Adjusted odds ratios of testing anti‐HCV‐positive were 2.66 for men versus women (<italic>P</italic> < 0.001), 1.25 for uninsured versus insured (<italic>P</italic> = 0.06), 0.70 for Hispanics versus non‐Hispanic whites (<italic>P</italic> = 0.005), and 0.93 per year of age (<italic>P</italic> < 0.001). Among 287 patients tested for HCV RNA (91% of all anti‐HCV‐positive cases), 175 (61%) were viremic (3.8% overall prevalence in cohort), which was 5% less likely per year of age (<italic>P</italic> < 0.03). Noninvasive staging of 148 (84.6%) chronic HCV patients identified advanced fibrosis or cirrhosis in 50 (33.8%), with higher adjusted odds ratios of 3.21 for Hispanics versus non‐Hispanic whites/Asians (<italic>P =</italic> 0.02) and 1.18 per year of age (<italic>P =</italic> 0.001). Other factors associated with significantly higher adjusted odds ratios of advanced fibrosis or cirrhosis were alcohol abuse/dependence, obesity, and being uninsured. <italic>Conclusion</italic>: In this low‐income, hospitalized cohort, 4% of 4582 screened baby boomers were diagnosed with chronic HCV, nearly twice the rate in the community; one‐third had noninvasive testing that indicated advanced fibrosis or cirrhosis, which was significantly more likely for Hispanics, those of older age, those with obesity, those with alcohol abuse/dependence, and those who lacked insurance. (H<sc>epatology</sc> 2015;62:1388–1395)</p> </abstract>